Pancho - ARA-ROS-74

Code: ARA-ROS-74
Mercy ID: V-01976-01
Encounter Date: 07/18/2005
Last: Arango
First: Rosa
DOB: 08/09/1974
County: Fulton
Street: 604 Hampton Rd.
City: Norcross
State: GA

Zip

30093-

Cell

(678) 760-8412

Family Status

Single parent w/children

COB

Colombia

Gender

Female

Housing

Not Homeless

Education Level

High school graduate

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	N/A	N/A	N/A
Father	N/A	N/A	N/A
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: N/A
Name of School: N/A
Grade: N/A
Who Can't Pickup the Child
Authoritation Parent: No
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: G. Landeros
Data Entry: K. Aleman